Dental and Periodontal Disease Screening-Child

Dental and Periodontal Disease Screening-Child

Dental and Periodontal Disease Screening

Summary of Recommendation and Evidence

Population

Recommendation

Grade
(What's This?)

Screening of both Genders

This screening is recommended for children.

B

There are a number of problems that affect the oral health of children, including tooth decay, thumb sucking, tongue thrusting, lip sucking, and early tooth loss. Even though baby teeth are eventually replaced with permanent teeth, keeping baby teeth healthy is important to a child's overall health and well-being.

Dental Problems

Tooth Decay

When plaque forms on the teeth, it produces acids. These acids, which are sticky, adhere to the teeth and attack the enamel. If not properly removed, the plaque can damage the tooth enamel. This condition is called tooth decay, and if it is left untreated, it can result in cavities, or small holes in the teeth. Lack of fluoride also contributes to dental decay.

Tooth decay is highly preventable with basic oral maintenance, such as flossing daily and brushing the teeth for two minutes following every meal or, at minimum, twice a day. When brushing one’s teeth, a fluoride toothpaste is important, as the fluoride helps teeth resist decay by hardening the enamel. Treatment options include removing the decay and filling the hole with a dental filling, replacing a part of the tooth with a crown, or removing infected pulp during a procedure known as a root canal. 

Thumb Sucking

It's normal and healthy for infants to suck their thumbs, fingers, pacifiers, or toys. Object sucking gives children a sense of emotional security and comfort. But if thumb sucking continues beyond the age of 5, when the permanent teeth begin to come in, dental problems can occur. 

Children must make the decision on their own to stop sucking their thumb or fingers before the habit will cease. To help toward this goal, parents and family members can offer encouragement and positive reinforcement. 

Tongue Thrusting

Tongue thrusting is the habit of sealing the mouth for swallowing by thrusting the top of the tongue forward against the lips.

If you notice symptoms of tongue thrusting, consult a speech pathologist. This person can develop a treatment plan that helps your child to increase the strength of the chewing muscles and develop a new swallowing pattern.

Early Tooth Loss

Premature loss of a child's baby teeth typically occurs from tooth decay, injury, or lack of jaw space.

If your child loses a tooth prematurely, your dentist may recommend a space maintainer. A space maintainer is a plastic or metal device that holds open the space left by the missing tooth. Your dentist will remove it once the permanent teeth begin to erupt.

What are periodontal diseases?

The word periodontal literally means around the tooth. Periodontal diseases, also called gum diseases, are serious bacterial infections that destroy the gums and the surrounding tissues of the mouth. If the inflammation is left untreated, the disease will continue and the underlying bone around the teeth will dissolve and will no longer be able to hold the teeth in place.

What causes periodontal disease?

Bacterial plaque buildup is the leading cause of gum disease. Other factors that contribute to gum disease include:

  • Genetics
  • Poor oral hygiene
  • Food stuck in the gums (may be due to a malocclusion)
  • Mouth breathing (may lead to severe drying of the gums and teeth in the front of the mouth)
  • Diet low in nutrients and/or a vitamin C deficiency
  • Diabetes
  • Hormonal changes in the body
  • Bruxism (repeated involuntary clenching or grinding of the teeth)
  • Certain medications (some medications can cause an overgrowth of the gums that can lead to periodontal disease)

What are the signs and symptoms of periodontal disease?

Signs and symptoms of gum disease includes:

  • Red, swollen, tender gums
  • Bleeding while brushing and/or flossing
  • Receding gums (gums that pull away from the teeth)
  • Loose or separating teeth
  • Persistent bad breath
  • Partial dentures that no longer fit
  • Pus between the teeth and gums
  • A change in bite and jaw alignment

What are the different types of periodontal disease?

Gingivitis: With gingivitis, the mildest form of periodontal disease, the gums are likely to become red, swollen, and tender, causing them to bleed easily during daily cleanings and flossing. Gingivitis can be divided into four groups, including: 

  • Acute. Gingivitis that has sudden onset, does not last long, and is painful.
  • Subacute. A less severe form of acute gingivitis.
  • Recurrent. Gingivitis that returns after treatment.
  • Chronic. Gingivitis that has slow onset, lasts a long time, and is usually painless.

Mild periodontitis: Untreated gingivitis leads to mild periodontitis. This stage of gum disease shows evidence of the development of periodontal pockets (gums pulling away from the teeth, causing the crevice between the teeth and gums to deepen) and early loss of bone around the teeth. 

Moderate to advanced periodontitis: This most advanced stage of gum disease shows significant bone loss, deepening of periodontal pockets, and possibly receding gums surrounding the teeth. Teeth may loosen and need to be extracted. 

What are the treatments for periodontal disease?

Treatment may include any, or a combination of, the following:

Tartar (calculus) and plaque removal beneath the gums: Deep cleaning (also called scaling and root planing) can help remove the plaque and calculus beneath the gum and infected tissue in the early stages of the disease, while smoothing the damaged root surfaces of the teeth. The gums can then reattach to the teeth.

Medication: Antibacterial medications may be placed topically in the periodontal pockets or taken orally.

Surgery: When the disease is advanced, the infected areas under the gums will be cleaned, and the tissues will then be reshaped or replaced. Types of surgeries include:

  • Pocket reduction
  • A regeneration procedure
  • A soft tissue graft
  • Crown lengthening